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Drug-Drug Interactions in Nursing Home Residents With vs Without Dementia
Mallory Go1, Laura A Reich2, Daniel A Harris3
1Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA; Center for Gerontology and Healthcare Research, Brown University School of Public Health, Providence, RI, USA.
Journal of the American Medical Directors Association
|August 11, 2026
Summary
Nursing home residents with Alzheimer's disease and related dementias (ADRD) face a higher risk of potential drug-drug interactions (DDIs). This study found increased prevalence and duration of DDIs in ADRD patients, highlighting a need for further investigation into adverse outcomes.
Area of Science:
- Gerontology
- Pharmacology
- Clinical Pharmacy
Background:
- Nursing home residents often have complex medication regimens.
- Alzheimer's disease and related dementias (ADRD) are prevalent in nursing home populations.
- Potential drug-drug interactions (DDIs) pose a significant risk to elderly patients.
Purpose of the Study:
- To compare the likelihood and duration of exposure to potential DDIs in nursing home residents with and without ADRD.
- To identify specific DDIs that differ in prevalence or duration between these groups.
Main Methods:
- Retrospective observational study using Medicare data (2018-2020) and Minimum Data Set 3.0.
- Included long-stay US nursing home residents aged 66+ with prescription data.
- Analyzed exposure to 98 potential DDIs, defining meaningful differences as ≥1% prevalence or ≥7 days' duration.
Main Results:
- Out of 485,251 residents, 70.1% had ADRD and 56.6% experienced a potential DDI.
- ADRD was associated with a higher prevalence of DDI exposure (PR 1.09).
- Residents with ADRD had higher predicted DDI prevalence (58.0% vs 53.3%) and increased exposure to CNS-active drugs.
Conclusions:
- Nursing home residents with ADRD experience a greater prevalence and longer duration of potential DDIs.
- Further research is needed to determine if these DDIs causally impact adverse events like falls.
- Intervention strategies may be necessary to mitigate DDI risks in this vulnerable population.
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